title: Clinical and behavioral correlates of achieving and maintaining glycemic targets in an underserved population with type 2 diabetes.
abstract: OBJECTIVE
  In an underserved Latino area, we established a disease-management program and proved its effectiveness. However, many patients still remained above target. This study was designed to evaluate which factors are associated with reaching program goals.
  
  
  METHODS
  This was a randomized, prospective, observational study in which patients enrolled in our program were followed for 2 years with outcomes, measures, and questionnaires assessed at baseline and at 6, 12, and 24 months.
  
  
  RESULTS
  Overall, A1C fell by 1%. Adherence to medication was the strongest predictor of reaching the target A1C of <8%; baseline A1C was also predictive. Knowledge scores increased in those who reached target, but the measures of self-efficacy and empowerment did not change for either group.
  
  
  CONCLUSIONS
  Diabetes management is effective in a lower-income Latino population. However, adherence was suboptimal even when medications were provided on-site for free. Further research into barriers associated with medication adherence is needed.
authors.affiliation: University of Southern California Keck School of Medicine, Los Angeles, California, USA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Ruelas
authors.forename: G Michael
authors.initials: GM
authors.lastname: Roybal
authors.forename: Yang
authors.initials: Y
authors.lastname: Lu
authors.forename: Dana
authors.initials: D
authors.lastname: Goldman
authors.forename: Anne
authors.initials: A
authors.lastname: Peters
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy* / Q000534:rehabilitation; D005500:Follow-Up Studies; D006630:Hispanic or Latino; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D015141:Los Angeles; D008507:Medically Underserved Area; D008687:Metformin / Q000627:therapeutic use; D016017:Odds Ratio; D010349:Patient Compliance; D011203:Poverty; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin